Lung (2017) 195:281–288 DOI 10.1007/s00408-017-9990-8
COPD
Inhaled Corticosteroid use and the Risk of Pneumonia and COPD Exacerbations in the UPLIFT Study Jaymin B. Morjaria1,2 · Alan Rigby1 · Alyn H. Morice1
Received: 5 December 2016 / Accepted: 20 February 2017 / Published online: 3 March 2017 © The Author(s) 2017. This article is published with open access at Springerlink.com
Abstract Rationale Unlike many other COPD studies, the 4-year UPLIFT trial permitted inhaled corticosteroid (ICS) use during run-in and treatment phases. This provided the opportunity to prospectively observe the continuing effects of ICS on respiratory events in closely observed COPD population. Objectives We aimed to determine rate and number of episodes of pneumonia and exacerbations of COPD in patients entering the study on no ICS, fluticasone proprionate (FP), and other ICS. Methods The UPLIFT dataset was examined retrospectively, and patients were divided into three groups based on their medications at entry: no ICS, FP and other ICS. Poisson regression was used to compare the frequency of respiratory adverse events. Measurements and Main Results At entry, the groups were well matched apart from a higher FEV1% predicted (38 vs. 41%; ICS vs. no ICS, respectively) and prevalence of current smoking (26 vs. 36%; ICS vs. no ICS, respectively). Incidence rates of pneumonia were significantly higher in patients taking ICS compared to no ICS (0.068 Electronic supplementary material The online version of this article (doi:10.1007/s00408-017-9990-8) contains supplementary material, which is available to authorized users. * Alyn H. Morice [email protected] 1
Centre for Cardiovascular & Metabolic Research, Hull York Medical School, University of Hull, Castle Hill Hospital, Castle Road, Cottingham HU6 5JQ, UK
2
Department of Respiratory Medicine, Royal Brompton & Harefield NHS Trust, Harefield Hospital, Hill End road, Harefield UB9 6JH, UK
vs. 0.056 respectively; p = 0.012). When the FP group was compared to the other ICS, the event rate was even higher (0.077 vs. 0.058, respectively; p
COPD
Inhaled Corticosteroid use and the Risk of Pneumonia and COPD Exacerbations in the UPLIFT Study Jaymin B. Morjaria1,2 · Alan Rigby1 · Alyn H. Morice1
Received: 5 December 2016 / Accepted: 20 February 2017 / Published online: 3 March 2017 © The Author(s) 2017. This article is published with open access at Springerlink.com
Abstract Rationale Unlike many other COPD studies, the 4-year UPLIFT trial permitted inhaled corticosteroid (ICS) use during run-in and treatment phases. This provided the opportunity to prospectively observe the continuing effects of ICS on respiratory events in closely observed COPD population. Objectives We aimed to determine rate and number of episodes of pneumonia and exacerbations of COPD in patients entering the study on no ICS, fluticasone proprionate (FP), and other ICS. Methods The UPLIFT dataset was examined retrospectively, and patients were divided into three groups based on their medications at entry: no ICS, FP and other ICS. Poisson regression was used to compare the frequency of respiratory adverse events. Measurements and Main Results At entry, the groups were well matched apart from a higher FEV1% predicted (38 vs. 41%; ICS vs. no ICS, respectively) and prevalence of current smoking (26 vs. 36%; ICS vs. no ICS, respectively). Incidence rates of pneumonia were significantly higher in patients taking ICS compared to no ICS (0.068 Electronic supplementary material The online version of this article (doi:10.1007/s00408-017-9990-8) contains supplementary material, which is available to authorized users. * Alyn H. Morice [email protected] 1
Centre for Cardiovascular & Metabolic Research, Hull York Medical School, University of Hull, Castle Hill Hospital, Castle Road, Cottingham HU6 5JQ, UK
2
Department of Respiratory Medicine, Royal Brompton & Harefield NHS Trust, Harefield Hospital, Hill End road, Harefield UB9 6JH, UK
vs. 0.056 respectively; p = 0.012). When the FP group was compared to the other ICS, the event rate was even higher (0.077 vs. 0.058, respectively; p
